The Development of Spinal Pain Beliefs: Patient Journey Mapping From Onset of Symptoms to MRI: A Qualitative Interview Study.

BACKGROUND

Beliefs about pain influence not only how individuals experience spinal pain but also their management behaviours. Health professionals are considered to play a central role in shaping these beliefs, yet little is known about how they evolve over time and which factors contribute to their development. This study explored how spinal pain beliefs develop across the patient journey from symptom onset to the point of MRI examination, applying the method of Patient Journey Mapping.

METHODS

Semi-structured interviews were conducted with six individuals experiencing long-term spinal pain. Interviews were transcribed ad verbatim and analysed using Malterud's systematic text condensation. An illustrative patient journey was then mapped, linking final code groups to touchpoints that reflected the development of pain beliefs in one informant.

RESULTS

Three code groups were constructed: (1) Influence of health professionals, (2) Societal and cultural influences, and (3) Lived experiences with pain. Informants' beliefs about spinal pain were dynamic, shaped and reshaped by influences across the three code groups, showing considerable change over time. Encounters with health professionals emerged as particularly influential, often reinforcing biomedical understandings. However, when information was conflicting or incongruent, it frequently gave rise to doubt and uncertainty.

CONCLUSION

This study demonstrates the value of Patient Journey Mapping in uncovering how spinal pain beliefs dynamically evolve through cumulative influences of healthcare encounters, social context, and lived bodily experiences. The findings highlight the critical role of health professionals, underscoring the need for clear and consistent communication to foster helpful understandings of pain and avoid reinforcing limiting or maladaptive understandings.